Basic Information
| Provider Information | |||||||||
| NPI: | 1346655511 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SURENDRANATH | ||||||||
| FirstName: | ANUDEEP | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MERCY LN STE 505 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018623127 | ||||||||
| FaxNumber: | 5016232405 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 MERCY LN STE 505 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018623127 | ||||||||
| FaxNumber: | 5016232405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2014 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301104705 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2084N0400X | E-13086 | AR | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.